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Margineanu I, Butnaru T, Gafar F, Baiceanu D, Dragomir R, Semianiv I, Mihaltan F, Munteanu I, Mahler B, Todoriko L, Margineanu S, Akkerman O, Stienstra Y, Alffenaar JWC. TB therapeutic drug monitoring - analysis of opportunities in Romania and Ukraine. Int J Tuberc Lung Dis 2023; 27:816-821. [PMID: 37880891 PMCID: PMC10599412 DOI: 10.5588/ijtld.22.0667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/14/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION: Therapeutic drug monitoring (TDM) could improve TB treatment outcomes by avoiding drug toxicity or underdosing. In this study, we describe the patient burden in three TB centres in Romania and Ukraine with a TDM indication, as per the current guidelines, in order to estimate the feasibility of implementing TDM.METHODS: A retrospective multi-centre study was conducted at the Iasi Lung Hospital (Iasi, Romania), Bucharest Marius Nasta Institute (Bucharest, Romania) and Chernivtsi TB Centre (Chernivtsi, Ukraine) in adult hospitalised TB patients.RESULTS: A total of 927 participants were admitted, of whom 37.8% had at least one indication for TDM, the most frequent being slow response to TB treatment (202/345, 58.6%); 55.5% had at least one cavity present on chest X-ray. Patients with a TDM indication stayed in the hospital for a median of 67 days and took on average 2 months more to reach a successful TB outcome.CONCLUSION: TDM could be a valuable tool to improve management of selected TB patients. The decision on whether to perform TDM is often delayed by 2 months due to waiting for culture results after treatment initiation. A randomised control trial should be performed in order to define TDM's precise role in TB therapy.
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Affiliation(s)
- I Margineanu
- Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands
| | - T Butnaru
- Prof Dr Marius Nasta Institute for Pneumology, Bucharest, Romania
| | - F Gafar
- Unit of Pharmacotherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - D Baiceanu
- Prof Dr Marius Nasta Institute for Pneumology, Bucharest, Romania
| | - R Dragomir
- Prof Dr Marius Nasta Institute for Pneumology, Bucharest, Romania
| | - I Semianiv
- Chernivtsi TB Expertise Centre, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - F Mihaltan
- Prof Dr Marius Nasta Institute for Pneumology, Bucharest, Romania
| | - I Munteanu
- Prof Dr Marius Nasta Institute for Pneumology, Bucharest, Romania
| | - B Mahler
- Prof Dr Marius Nasta Institute for Pneumology, Bucharest, Romania
| | - L Todoriko
- Chernivtsi TB Expertise Centre, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - S Margineanu
- Department of Computer and Data Sciences, Ion Ionescu de la Brad Iasi University of Life Sciences, Iasi, Romania
| | - O Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Tuberculosis Center Beatrixoord, University Medical Center Groningen, University of Groningen, Haren
| | - Y Stienstra
- Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - J-W C Alffenaar
- Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands, Faculty of Medicine and Health, School of Pharmacy, and, Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Westmead Hospital, Sydney, NSW, Australia
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